Zolpidem

Zolpidem is a type of sleeping pill that treats bad bouts of insomnia.

You can only get zolpidem on prescription. It comes as tablets, including ones that dissolve under your tongue.

It's also known as:

  • Edluar
  • Nytamel
  • Stilnoct
  • Zoldem
  • Zolnod

Uses of zolpidem

Zolpidem boosts the effectiveness of a chemical in the brain called gamma-aminobutyric acid (GABA) to improve sleep.

It helps you fall asleep more quickly and also helps to stop you waking up during the night.

Get emergency help

You might need emergency help if you get serious side effects, take too much or have a serious allergic reaction (anaphylaxis) to zolpidem.

If you take too much

Immediate action required: Call 112 or 999 or go to your nearest emergency department (ED) if you:

  • take more than your prescribed dose of zolpidem

Do not drive yourself to the ED. Get someone else to drive or call 999 or 112 for an ambulance.

Bring the zolpidem packet or leaflet plus any remaining medicine.

Serious allergic reactions

A serious allergic reaction (anaphylaxis) from taking zolpidem is rare.

Immediate action required: Call 999, 122 or go to your nearest ED if you:

  • get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • are wheezing
  • get tightness in the chest or throat
  • have trouble breathing or talking
  • have swelling in your mouth, face, lips, tongue or throat

Serious side effects

Urgent advice: Stop taking zolpidem and call your GP straight away if you:

  • develop memory loss (amnesia)
  • see or hear things that are not real (hallucinations)
  • fall over – particularly if you are over the age of 65
  • think things that are not true – these are called delusions
  • feel low or sad – this could be a sign of depression
  • have sleep problems that get worse after taking zolidem
  • feel drowsy or very sleepy
  • feel dizzy
  • get blurred vision, see double or have other sight problems
  • have a loss of appetite
  • start sleep walking or other unusual behaviour
  • feel intense elation or euphoria
  • have problems with your liver, which will show up on blood tests
  • feel dependent on zolidem to feel normal
  • have breathing problems

Check if you can take zolpidem

You can take zolpidem if you're 18 or over. But it is not suitable for some people.

Check with your GP or pharmacist if you:

  • have had an allergic reaction to any medicines in the past
  • have liver or kidney problems
  • have had heart problems or a condition called long-QT-syndrome
  • have myasthenia gravis, an illness that causes muscle weakness
  • have breathing problems or sleep apnoea
  • have ever had mental health problems
  • have ever had issues with alcohol or drugs
  • are pregnant, trying to get pregnant, or breastfeeding

See the patient information leaflet that comes with your medicine for a full list of conditions to check with your GP.

Contraception and fertility

Zolpidem does not affect how contraception works, including the combined pill and emergency contraception.

There is no evidence that zolpidem reduces fertility in either men or women.

Talk to your GP or pharmacist if you're trying for a baby. Your GP may review your treatment.

Pregnancy and zolpidem

Do not take zolpidem if you're pregnant. It may harm your baby. 

Taking zolpidem can increase the risk of:

  • your baby being born early (before 37 weeks) 
  • your baby having a lower birth weight
  • your baby having a cleft lip and palate
  • your baby moving less and their heart rate changing in the womb

Taking zolpidem right up until you go into labour can increase your baby's chances of having withdrawal symptoms at birth.

If zolpidem is taken at the end of pregnancy or during labour, your baby may show muscle weakness, a drop in body temperature, difficulty feeding and breathing problems.

Breastfeeding and zolpidem

Do not breastfeed if you are taking zolpidem.

Zolpidem passes into breast milk in very small amounts.

Talk to your public health nurse or GP if you are taking zolpidem.

When you start taking zolpidem

Always take zolpidem exactly as your GP has told you.

Do not take more than your prescribed dose.

You can take zolpidem with or without food. Swallow the tablet whole with a drink of water. Do not crush or chew it. 

Zolpidem takes around 30 minutes to work, so take it just before you go to bed.

Make sure at least 8 hours have passed between taking zolpidem and any activities where you need to be alert, such as driving.

Avoid alcohol

Do not drink alcohol while you are taking zolpidem.

Alcohol and zolpidem together can make you sleep very deeply. You might not breathe properly and can have difficulty waking up.

Avoid caffeine

Do not have drinks with caffeine while you're on zolpidem. Caffeine has the opposite effect of zolpidem on your body and stops it working.

Zolpidem will make you sleepy (drowsy). It affects people in different ways and some people may feel sleepier than others. This includes feeling sleepier during the daytime.

Vehicles, machinery and zolpidem

Do not drive a car, ride a bike, or use tools or machines until you see how zolpidem affects you.

The day after you take Zolpidem you may:

  • feel drowsy, sleepy, dizzy or confused
  • take longer to make decisions
  • have blurred or double vision
  • be less alert

You should wait at least 8 hours before driving, using machinery or working at heights after you take zolpidem

Talk to your GP or pharmacist if you are unsure if it is safe for you to drive while taking zolpidem.

See your patient information leaflet for more information about possible side effects which could affect your driving.

Dosage

Usually you will take one 10mg tablet every night. 

You might start on a lower dose of 5mg if you:

  • are over 65
  • have kidney or liver problems

Your GP might ask you to take a tablet just 2 or 3 nights a week, instead of every night.

How long you will take it 

You will usually take zolpidem for between 2 days and 4 weeks.

Your body gets used to this medicine quickly. This means it will not work as well the longer you take it. 

Talk to your GP if you feel you need to take it for longer than 4 weeks. They will be able to discuss your sleep problems and recommend other things that may help.

Stopping taking zolpidem

Do not stop taking this medicine suddenly. You may get withdrawal symptoms. Tell your GP if you want to stop taking zolpidem.

Withdrawal can feel like all of the following symptoms:

  • your insomnia returns more intensely than before
  • you feel anxious, restless, have mood changes
  • you become very sensitive to light, noise, and being touched

Urgent advice: Contact your GP straight away if you:

  • feel anxious, restless, irritable or confused
  • have a headache
  • get palpitations
  • have nightmares or hallucinations
  • are more sensitive to light, noise and touch than normal
  • lose touch with reality
  • feel distant from your body
  • feel numbness and tingling in your hands and feet
  • have aching muscles
  • get stomach problems
  • have problems sleeping
  • have fits (seizures)

Your GP might recommend reducing your dose of zolpidem slowly over a few days or weeks.

Find out more about stopping taking zolpidem

Addiction and zolpidem

You are unlikely to become addicted to zolpidem if you just take it for a few weeks. But your body can become dependent on zolpidem.

Talk to your GP or pharmacist especially if you have been taking zolpidem for a long time.

If you forget to take it

If you forget to take your tablet at bedtime, do not take it at any other time. Skip the missed dose and take your next dose as normal, before bedtime the next night.

Never take 2 doses at the same time. 

Never take an extra dose to make up for a forgotten one.

Side effects

Zolpidem can cause side effects, but not everyone gets them.

A common side effect is a bitter or metallic taste in your mouth, or a dry mouth. Talk to a GP or pharmacist if these side effects bother you or do not go away.

Using a mouthwash before bedtime may help. 

Zolpidem can also cause:

  • dizziness
  • headache
  • feeling or being sick (nausea or vomiting)
  • diarrhoea
  • stomach pain
  • back pain

Sleepwalking and zolpidem

Some people have reported doing things such as sleepwalking, making food, and making phone calls while they are asleep after taking zolpidem.

This is more likely to happen if you take zolpidem with alcohol or other medicines that make you drowsy, including medicines for mental health problems like depression or anxiety.

If this happens to you, ask your GP for advice.

Zolpidem and other medicines

Tell your GP or pharmacist if you are taking any other medicines. This includes herbal remedies, vitamins or supplements.

Some medicines and zolpidem can interfere with each other. This can increase your chance of side effects.

Certain medicines may increase the drowsy effects of zolpidem.

Talk to your GP or a pharmacist before starting on zolpidem if you take:

  • medicines for hay fever, rashes or other allergies that can make you sleepy (drowsy antihistamines)
  • antipsychotics
  • medicines to treat depression
  • medicines for epilepsy
  • Medicines used during surgery or dental treatment
  • clarithromycin
  • erythromycin
  • rifampicin
  • St John's wort
  • medicines to calm or reduce anxiety
  • medicines for sleep problems
  • medicines used to treat fungal infections, such as ketoconazole and itraconazole
  • ritonavir - for HIV infections
  • strong painkillers, such as codeine, methadone, morphine, oxycodone, pethidine or tramadol

Herbal medicines and zolpidem

Do not take any herbal remedies that make you feel sleepy while taking zolpidem.

These can increase the drowsy effects of your medicine.

Recreational drugs and zolpidem

You could go into a very deep sleep and have difficulty waking up if you take zolpidem while using:

  • cannabis
  • heroin
  • methadone

Talk to a GP if you think you might use recreational drugs while you're taking zolpidem.

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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